Methotrexate

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Molecule Description

Methotrexate is used to treat rheumatoid arthritis, psoriasis, and certain other autoimmune or inflammatory conditions. As an antimetabolite, Methotrexate blocks the activity of an enzyme required for cell growth, especially in rapidly dividing immune cells. Slowing down this abnormal immune activity helps reduce inflammation, joint pain, swelling, and skin plaque formation. Methotrexate is a prescription-only medicine and should be taken strictly under medical supervision. The dosage and weekly schedule are carefully determined by the doctor based on the patient’s condition, body response, and other ongoing treatments. It is extremely important to follow the exact dosing instructions, as exceeding the prescribed dose can lead to serious side effects. Before starting Methotrexate, patients must inform their doctor if they are pregnant, planning pregnancy, or breastfeeding, as this molecule is unsafe in these situations. It is also essential to share details about all current medicines, supplements, and any existing medical problems such as liver or kidney disorders. Regular monitoring through blood tests may be required during long-term therapy.

Uses

To treat psoriasis
To treat rheumatoid arthritis
To treat various types of cancers such as breast and lung cancers
Also used as a single agent or in combination with anti-cancer medications

Contraindications

When should one not use Methotrexate

Allergic reaction to this medicine
Pregnancy and breastfeeding
Severe liver or kidney disease
Decreased platelets and white blood cells
If you have recently received a live vaccine
If you have ulcers in the mouth
If you have fever, joint pain

Side effects

Common side effects of this drug are:

Diarrhea
Mouth ulcers
Weakness
Menstrual problems
Skin rash
Persistent cough
Joint pain, muscle pain
Stomach pain
Swelling of feet
Dizziness
Yellowing of the skin (liver damage)
Fever with chills
Unusual bleeding
Blurred vision
Temporary hair Loss
Loss of appetite
Difficulty in passing urine
Nausea or vomiting
Decrease white blood cells

Precautions and Warnings

Pregnancy

It is highly unsafe to use during pregnancy. Human and animal studies have shown significant side effects on fetus like birth defects or miscarriage. If you are a woman of childbearing age, strictly use contraception and avoid pregnancy.

Breast Feeding

Methotrexate is strictly not to be taken during breastfeeding.

Driving

Do not drive until your vision is clear. It may cause dizziness, drowsiness.

Alcohol

Alcohol should be avoided while receiving Methotrexate as it increases the chances of damaging your liver.

Other General Warnings

Talk to your doctor if

You have kidney disease, ulcers in the stomach, diabetes mellitus or any infections
You have received any live vaccines
You should avoid having a baby at least 6 months after stopping Methotrexate as this medicine affects sperm and egg production
If you experience cough with blood or pink color sputum immediately inform your doctor
Taking more medicine than what is prescribed by your doctor can be very harmful and should be avoided
If you are on this medicine for the long term, regular health check-ups are required

Mode of Action

How Does It Work?

It works by stopping or slowing down the growth of cancer cells and suppress the immune system. In rheumatoid arthritis, it works by decreasing the activity of the body's immune system. This decrease swelling, pain and stiffness, and improves function. It also works by slowing down the rapid growth of skin cells.

Interactions

Interactions with other medicines

Using Methotrexate with individual Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as Ibuprofen, Aceclofenac, Acemetacin and Diclofenac can cause severe and sometimes fatal bone marrow suppression, aplastic anemia (in which the body stops making new blood cells), and gastrointestinal toxicity
When used along with radiotherapy, Methotrexate may increase the risk of cell death in soft tissues and bones
Live vaccines
Cyclosporin’s (used in transplantation)

Interactions with food items

No information is available on interactions of Methotrexate when taken with food, consult your doctor or pharmacist for further details.

Dietary Restrictions

No information is available on dietary restrictions while you are taking Methotrexate, consult your doctor or pharmacist for further information.

Dosage

Overdose

In overdose, vomiting, diarrhea and gastrointestinal bleeding may occur. Severe bone marrow suppression may occur. Liver toxicity is more likely in patients with pre-existing risk factors for liver disease. Patients may see symptoms like sudden shortness of breath and a dry, persistent cough and also fever. A single overdose also has shown this fatal side effect. Another cause of death is bone marrow suppression. Several deaths have been reported all over the world from Methotrexate overdose. Because they had been accidentally taking medicine daily instead of once a week dose as prescribed. This grave mistake should be avoided on part of the prescriber, pharmacist, patient and a caregiver.

Missed a Dose

If you missed any dose, take it as soon as you remember. Skip the missed dose if it is time for your next dose. Do not take an extra dose of medicine to make up the missed dose. Be very careful with the dosage in terms of strength and duration spacing with this medicine. Strictly adhere to your prescribed dose of medicine.

Frequently Asked Questions (FAQs)

Prolonged use of Methotrexate may cause liver damage, including cirrhosis (irreversible scarring of the liver), which may be fatal. High doses of Methotrexate can also damage the kidneys and cause kidney failure. People with psoriasis or rheumatoid arthritis may not be suitable for Methotrexate if they have alcoholism, alcoholic liver disease or other chronic liver diseases, have an immunodeficiency syndrome, have a blood deficiency disorder such as anemia (low red blood cell count), leukopenia (low white blood count) or thrombocytopenia (low blood platelet count).

Methotrexate is used to treat rheumatoid arthritis and psoriasis by reducing inflammation and slowing the overactive immune response.

Methotrexate is usually taken once a week, not daily. Always follow your doctor’s exact instructions to avoid harmful side effects.

No. Methotrexate is unsafe during pregnancy and breastfeeding. Inform your doctor immediately if you are pregnant or planning to conceive.

Yes. Your doctor may advise regular blood tests to monitor liver function, kidney health, and blood cell levels to ensure safe treatment.

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